IN commemoration with World Arthritis Day – held annually on Oct. 12 – Jeddah's King Faisal Specialist Hospital and Research Center (KFSH) marked the day this year with the theme “Let's Work Together” on Oct. 14 at the Red Sea Mall. The workshop aimed to raise awareness about arthritis, the increasingly common, but little understood condition. Running parallel to this effort was another, that aimed to raise awareness about rheumatoid arthritis (RA). A lecture was delivered by Dr. Hussein Al-Halabi, the director of academic affairs and a rheumatism consultant at KFSP this Monday to brief representatives of the media on the causes, symptoms and treatment of this branch of arthritis. The workshop came as one of KFSP's many dynamic endeavors to raise awareness about and publicize those illnesses that often go undiagnosed due to the lack of knowledge about them. “Rheumatoid arthritis affects approximately one percent of the adult population worldwide, and twice as many women as men suffer from the disease which can start at any age, but usually occurs between 40 and 70 years,” remarked Dr. Al-Halabi. “An acute diagnosis of rheumatoid arthritis can be difficult as there is no single (and therefore, definitive) test for the condition and symptoms only develop over time. The diagnosis is normally based on the number of symptoms and reactions the patient has.” He added that: “70 percent of the patients show signs of permanent joint damage within two years of the start of this condition, so it is very important that they receive an early diagnosis and begin effective treatment as soon as possible.” An online survey for World Arthritis Day, completed by over 36,000 world respondents, revealed that access to psychological support and self-management courses could help people with arthritis/rheumatism cope more effectively with their condition and achieve better quality of life. Health care professionals, patients and their caregivers - all of whom responded to the survey – highlight the importance of integrating psychological support into the standard treatment regime. “97 percent of the patients with rheumatoid arthritis indicated that this condition affects them and their loved ones emotionally, while 5 percent said that it led them to depression,” remarked Dr. Baher Massoud, the Area Medical Officer of the Wyeth Pharmaceuticals (MENA region). “Despite the scale of the problem, only 35 percent of the survey respondents said that they raise the issue of this emotional impact with their doctor. Clinical data demonstrates that the quality of life of these patients can be substantially enhanced by introducing special coping strategies.” What is Rheumatoid Arthritis (RA)? Rheumatoid arthritis or inflammatory arthritis is a systemic disease which affects more than 1% of the people globally, but still baffles researchers and health professionals as to its true nature. What is known is that RA is the body's response to an obscure antigen. The condition is characterized by morning stiffness and inflammation of the joints. It is imperative to diagnose this condition early; with treatment and exercise, patients can effectively manage the disease without severe deformity and disability. Causes The causes of RA are still unknown though it is thought to be inherited via certain genes that affect the way the immune system works. People with the gene called HILA-DR, for instance, seem to be more susceptible to this condition than others. Symptoms RA is a progressive disease with symptoms and evidence of joint destruction becoming increasingly worse over time which may lead to irreversible joint damage. The clinical features of RA include: – Stiffness, commonly in the morning. – Joint swelling which can occur in any joint, though most often in smaller ones. – Tiredness, fever, weight loss and depression. How is RA diagnosed? The diagnosis is normally based upon a number of symptoms including the pattern of affected joints, X-Ray and/or scan results which show joint damage and high levels of an antibody called rheumatoid factor (RF) in the blood. Need for early treatment Joint destruction can occur rapidly in the early stages of RA and joint damage is evident in 70% of patient X-Rays taken within the first two years of the disease. Furthermore, magnetic resonance imaging (MRI) can detect changes in joint structure from as early on as two months after disease onset. Because joint damage can occur very quickly at the beginning of the disease, there may be a need to initiate aggressive treatment very soon after RA diagnosis, before a significant amount of irreversible joint damage has occurred. Treating RA The treatment of RA has changed considerably within the past decade, moving from a conservative approach designed to control clinical symptoms to a more progressive approach designed to limit joint destruction and disability. The main goal of treatment for rheumatoid arthritis is to stop disease progression, otherwise known as achieving remission. Historically, RA has typically been treated with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and simple analgesics to relieve pain and symptoms New developments Recently, a new class of medicines called biologics has been developed to treat rheumatoid arthritis. Unlike other therapies which are made by combining man-made chemicals, biologics are created from living human or animal proteins. Whereas other systemics have a broad impact on the immune system, biologics are designed to selectively target mediators believed to be involved in the process of inflammation. Some biologics work by inhibiting the action of a naturally occurring protein in the body called ‘tumour necrosis factor alpha (TNF-?) and are known as anti TNFs.
